INTEGRATED

HELMINTH
Control
Program (IHCP)

DATE
VENUE
OBJECTIVES of the
Presentation
 To present overview and objectives of the
INTEGRATED HELMINTH Control Program
(IHCP)
 To give updates on the status of Soil-
Transmitted Helminthiasis in the Philippines
 To present issues and challenges in
Program Implementation and some
recommendations
 Outline of Presentation
 Overview of STH and current prevalence rate
 Objectives and overview of the INTEGRATED
HELMINTH Control Program (IHCP)
 DepEd Issuance on deworming
 Key notes on IHCP (When? Who? What? Where?)
 Management of adverse effects
 Effects of Deworming
 Roles and responsibilities
 Issues,
concerns and recommendations of the
program
Soil-transmitted
Helminthiasis
Soil-transmitted Helminth Infections
(ascariasis, trichuriasis, hookworm infection)
 Caused by:
 ingestion of eggs from
contaminated soil
(Ascaris and Trichuris) or
 skin penetration by larvae
from the soil (hookworms)
 Poor environmental
sanitation (open
defecation) and poor
personal hygiene (dirty
hands) are major factors
for exposure

Factors that promote worm infections

 What are the signs and symptoms
of STH Infestation?

• Abdominal pain
and enlargement
• Weight loss
• Anemia
• Malnutrition
• Loss of Appetite
 What harm does helminth do?

• Growth stunting

• Decreases
physical activity

• Poor mental
and physical
activity that
affect school
performance
 Status of Soil Transmitted
Helminthiasis in Region VI
STH Intensity of STH Infection (%)
Rank Region Cumulative Low Moderate High
Prevalence intensity intensity Intensity
1 5 67.4 51.0 44.23 4.79
2 8 55.9 61.2 35.05 3.73
3 4B 40.4 62.9 31.01 6.13
4 ARMM 37.4 61.0 34.52 4.52
5 3 32.5 73.5 25.29 1.16
6 6 28.6 67.4 26.96 5.63
7 9 26.9 71.2 25.63 3.20
8 12 22.5 81.3 17.02 1.65
9 CARAGA 22.3 74.5 24.74 0.77
10 NCR 21.8 62.0 36.08 1.90
11 7 21.1 85.4 12.32 2.29
12 10 20.5 77.5 21.43 1.10
13 4A 20.4 66.8 31.06 2.13
14 1 19.2 70.2 28.07 1.75
15 2 13.0 74.7 23.60 1.69
16 11 12.0 93.2 6.02 0.80
17 CAR 7.1 89.7 10.26 0.00
Overall 28.4 67.7 29.01 3.26

Source: DOH-RITM, 2013-2015

 Status of Soil Transmitted
Helminthiasis
28.4%
NATIONAL PREVALENCE SURVEY
OF SOIL TRANSMITTED
HELMINTHS (STH) AMONG PUBLIC
SCHOOL CHILDREN (DAYCARE, School Aged
Children
ELEMENTARY & HIGH-SCHOOL) IN
THE PHILIPPINES;
RITM 2015 Overall cumulative
prevalence with 3.26% PHII
from follow up studies in all
Provinces in the Philippines.

-DOH-RITM 2013-2015
 OBJECTIVES OF THE IHCP
GENERAL:
 To improve the service delivery of mass drug administration for the
prevention and control of soil-transmitted helminthiasis (STH).

SPECIFIC:
1. To increase national and provincial MASS DRUG ADMINISTRATION
coverages to at least 85%.
2. To improve efficiency of health service delivery and to maximize limited
resources by:
a. harmonizing the schedule of community & school based MDA;
b. combining drug administration especially for school age children
3. To improve quality and timeliness of recording and reporting for
evidence-based decision making by ensuring completeness and
accuracy of data.
MASS DRUG ADMINISTRATION
DepEd Policy for
School-based MDA

 DepED Order no. 65

series of 2009:
Implementation of
Essential Health Care
Program (EHCP) for
school children
 Includes semi-
annual deworming
for all children
Two Components MDA
National School Community Based
Deworming Month Deworming Month
(NSDM) (CBDM)
 Where and When does the
HSCMDA be done?
Month Where Target Population Drug of
Choice
January Community 1 to 4 years old 400mg
SCHOOL 5 to 18 years old enrolled in public schools Albendazole
Community 5 to 18 years old not enrolled in public or 500mg
schools Mebendazole

July Community 1 to 4 years old 400mg

SCHOOL 5 to 18 years old enrolled in public schools Albendazole
Community 5 to18 years old not enrolled in public or 500mg
schools Mebendazole

NTD-MIS: “Doing business NOT as usual”

 Who should be dewormed?

1 to 4 years 5 to 12 years 13 to 18 years old

old old
Target 10.23% 19.28% 12.86%
populations
size as % of
total
Pre-school 32.14%
Philippine (PSAC) School-Age (SAC)
population:

Reference: DOH-
Epidemiology Bureau and
Department of Education

NTD-MIS: “Doing business NOT as usual”

What is our Deworming target
coverage?

Target
Soil-Transmitted
Helminthiasis MDA
COVERAGE
85%

NTD-MIS: “Doing business NOT as usual”

 School Deworming coverage in Region VI
90

88

86

84 Jul-17
Jan-18
82

80

78
Deworming coverage

JULY 2017 JANUARY 2018

Total Population Total no. of % Acc Total Population Total no. of % Acc
enrolled children given ALB enrolled children given ALB

1,769,088 1,573,017 88.9 1,680,647 1,391,404 82.8

 Common Drug Side Effects

• Dizziness
• Nausea
• Headache
• Vomiting
Based on AO: 2010-0023
A LIGHT TO FULL MEAL BEFORE
DEWORMING WILL REDUCE OR PREVENT
ADVERSE REACTION TO THE DRUG
RECOMMENDATIONS:
 Conduct School feeding before
deworming
 Conduct deworming after recess
Effects of Deworming
 Improved iron stores & hemoglobin levels
 Improved growth
 Improved food intake
 Improved cognitive performance
 Reduced incidence of clinical
complications
Roles and Responsibilities based on
DM: 2016-0212

PTA • Facilitates preparation of light meals for

President/Officer students
Class Teacher • Facilitates feeding of students
• Administers albendazole tablets to each
student`
• Fills out coverage forms
Roles and Responsibilities
Clinic Teacher • Oversees combined MDA in school
• Collects and collates coverage forms from
all classes
• Assists the rural health midwife in
assessment and management of AEs
Rural Health • Oversees MDA in school
Midwife • Assesses and manages mild and
moderate AEs
• Records AEs
• Refers unresolved
moderate/severe/serious AEs to
RHU/Hospital
Barangay Health • Assists RHMs in assessment and
Worker management of AEs
Roles and Responsibilities
DepEd Nurse • Oversees conduct of MDA in school district
• Distributes albendazole tablets to clinic
teachers
• Collects and collates coverage and
Adeverse Effects (AE) forms in school
district

Municipal • Oversees AE assessment and

Health management in school
Officer/Public district/municipality
Health Nurse • Receives referral for unresolved moderate
to severe AEs
• Distributes tablets and AE drugs to Rural
Health Midwifes(RHMs)
• Collects and collates coverage
Roles and Responsibilities
DepEd Division • Oversees conduct of MDA in the province
Medical Officer • Collates coverage forms provided by DepEd
nurses

Provincial • Oversees conduct of MDA and AE

Health assessment and management in the
Officer/Provinci province
al STH • Collates coverage and AE forms provided
Coordinator by MHOs/PHNs
ISSUES & CHALLENGES
PATIENT RELATED
 Parents not giving consent to deworm
-Misconception(Cultural/Religious/Superstitious)
-Fear (side effects and current issue)
 Students
-Loss of consent
-refusal of students

PROVIDER RELATED
 Teachers
-Fear
-Do not deworm but instead waits for the health worker
-No follow-up for missed children
-Lets the children brings the drugs
RECOMMENDATIONS
 Re-orientations
for parents, students and teacher
on the importance of deworming

 Conduct multi-sectoral meetings with DepEd and

health offices for improved implementation

 Integratewith other activities such as nutrition

month celebration, acquaintance program,
parents teachers meetings and school
conferences
RECOMMENDATIONS
 Scheduleany school date from July or earlier to
conduct deworming activities together with
feeding and programs that would highlight
importance of deworming and personal hygiene
(handwashing and toothbrushing)
 POINTS TO REMEMBER:

Mass drug administration (MDA) is used as

PREVENTIVE CHEMOTHERAPY that aims to control
morbidity of an eligible population even without
the benefit of diagnostic examinations.

ALBENDAZOLE/MEBENDAZOLE are the drug of

choice for mass deworming, being safe, economical
and simple because they are given as single dosage,
thus making the administration easy even for non-
health workers.
 POINTS TO REMEMBER:

Anthelmintics are Safe for Children

A light/full meal prior to deworming reduces
adverse events/side effects
All common adverse effects can be managed at
school or referred to the RHUs and if the
symptoms persist, the doctor will be consulted
Erratic migration (worms coming out from the
mouth or nose) should not be feared
Providing proper information and reassuring
students and parents are very important
THANK YOU